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Hypercalcaemia - Management
Basis for recommendation
These recommendations are based mainly on international guidelines on the management of asymptomatic primary hyperparathyroidism [Bilezikian et al, 2009; Eastell et al, 2009; Khan et al, 2009; Silverberg et al, 2009; Udelsman et al, 2009]. In addition:
- The information that, following specialist endocrine assessment, monitoring of people with asymptomatic primary hyperparathyroidism (who have no indications for parathyroidectomy or decline parathyroidectomy) may be done in primary care, if this is agreed locally, is based on what CKS considers to be acceptable practice.
- The recommendation to monitor blood pressure every 6 months is based on expert opinion from a narrative review [Davies et al, 2002]. Hypertension is more common in people with primary hyperparathyroidism compared with the general population [Chan et al, 1997]. The cardiovascular risks are not known [Bilezikian et al, 2009] and hypertension does not improve following parathyroidectomy [Chan et al, 1997].
- In the absence of evidence or published opinion, the recommendation to monitor for symptoms of hypercalcaemia opportunistically is based on what CKS considers to be good clinical practice.
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